The Intuition Network, A Thinking Allowed Television Underwriter, presents the following transcript from the series Thinking Allowed, Conversations On the Leading Edge of Knowledge and Discovery, with Dr. Jeffrey Mishlove.

STRESS MANAGEMENT with JANELLE M. BARLOW, Ph.D.

JEFFREY MISHLOVE, Ph.D.: Hello and welcome. Today we're
going to be examining one of the major factors that affects modern life,
and that is stress. Stress is something which is reported throughout our
environment. It is something which is being discussed more and more as
part of our own physiology, and responsible for our health and well being.
Yet what is stress, really, and what kind of control do we have over stress?
We're going to be examining the topic of stress management, and my guest,
Dr. Janelle Barlow, is an expert on stress management. She's been teaching
stress management to business executives for over ten years now. She is
the chief trainer in the United States for Time Manager International,
the largest European management training company, and she is also the author
of a management training manual called The StressManager.
Welcome, Janelle.

JANELLE BARLOW, Ph.D.: Thank you.

MISHLOVE: It's a pleasure to have you here.

BARLOW: It's nice to be here.

MISHLOVE: Let's talk about stress specifically. Many people
have heard of the fight-or-flight syndrome, when you get really tensed,
and you don't know quite what to do. That's been rather specifically delineated
at this point in time, hasn't it?

BARLOW: Yes, it was, by Walter Cannon. That was a number
of years ago, and it's pretty well stood the test of time. Basically what
happens is that when the body is exposed to something from the outside
that it feels it needs to get activated towards, then the brain does that
for the body automatically.

MISHLOVE: But more than just arousal.

BARLOW: Oh yes, more than arousal, that's right. The whole
purpose of the stress response is to enable the human to survive.

MISHLOVE: For example?

BARLOW: Well, for example, if a dog attacked you -- that's
much more reasonable than the tiger that's always talked about -- if a
pit bull came after you, your body would need to do certain things for
you to survive. If you're nearly killed in a car crash, your body needs
to do certain things, to enable you to organize yourself in such a way
that you can survive. So basically it's a survival response.

MISHLOVE: In other words, people's hands get cold because
the blood leaves the extremities, in case a tiger might bite them off,
or something of that sort.

BARLOW: Well, it's basically to protect the body's blood
supply, and also the blood needs to go to specific places. That's the technicalities
of it.

MISHLOVE: So the stress response is a normal human response.

BARLOW: Absolutely. You know, I talk with a lot of people
about it, and they say, "Well, maybe we can get rid of it." But if you
got rid of it you wouldn't be human. It's part of defining who we are,
is to have this response.

MISHLOVE: And you in your work focus in on the practical
things that people can do in dealing with stress in their lives. You're
a trainer, you're not really a research scientist.

BARLOW: That's right.

MISHLOVE: When you work with people, I think one of the
most important things that comes up is their awareness of whether or not
they're having a stress response, and just how it manifests for each individual.

BARLOW: That's right. The awareness, in my mind, is the
biggest part of the battle. If you can get people to be aware of how they're
responding, because in today's world -- and there's quite a bit of research
now to support this -- it seems as if the things that are really getting
to us are not the big things, the identifiable, big things. It's the little
tiny things that go on all the time. It's missing a parking place; it's
the person in the grocery line with eleven items in their basket and they're
only supposed to have ten items.

MISHLOVE: Having the phone ring when you're trying to
concentrate.

BARLOW: Or calling up somebody and you can't even hear
who it is because the receptionist has been saying this name so many times,
and then you get put on hold without wanting to be put on hold, and then
you get disconnected, and then the computer doesn't work. There are so
many small things that are going on all the time.

MISHLOVE: These things that activate or trigger the stress
response are called stressors.

BARLOW: That's right, you can think about them as stressors.
And then what the body does, is it does something in relationship to these
stressors. That's a really useful model to have, because then you can always
do one of two things. You can either change the stressor, if you can, but
sometimes you can't; or you can change the way that you respond to it.
And you probably always have something you can do about that.

MISHLOVE: So would you say then that stress always exists
in the body, not outside of it?

BARLOW: Well, stress is a definition of what humans do
in relationship to something else; so yes, it is inside the body. The stressors
are outside the body, and that's what the body is responding to.

MISHLOVE: Now, when a person is experiencing a lot of
stress, does that mean they're not managing their stress response very
well? For example, two people under identical conditions -- one person
might be fuming, and with hunched shoulders, and barking at people, and
another person might appear to be for all the world very relaxed.

BARLOW: Well, they may be, and then it's a question of
how they're processing this particular event inside their minds, because
you can put people in exactly the same situations, and they will have totally
different responses to it. I always remember a story I saw on television
once, about the mudslides that were taking place in Southern California,
and a TV interviewer coming up to one man whose house had been destroyed.
His reaction was what you would typically expect. He was very upset; his
house had been destroyed; what was he going to do? The government should
do something about this. He was crying. It was a very strong presentation
for the evening news. Then the reporter went down the street to another
man who had suffered the same fate, and his response was a little different.
It was, "Well, my family got out all right. We can save a lot of this stuff.
It's been buried in the mud, but we can dig out the pictures." And then
his last comment, which was the telling one, was, "You know, I've always
wanted a third bedroom." The same situation, and a very different response.

MISHLOVE: In other words, the attitude with which we approach
life actually seems to affect the way our physiology reacts towards outside
stress.

BARLOW: As long as it's a social stressor. When it's a
physical stressor, then I'm not so sure that that's true. For example,
if you put people in a sauna for three hours and the temperature is close
to two hundred degrees, I don't know how many people could control their
response to that. That's a physical stressor. But primarily today we're
dealing with social stressors in any case, so the physical question is
sort of moot.

MISHLOVE: One thing I've heard a lot about is the Holmes-Rahe
Scale. This is a list, I understand, of social circumstances that people
go through in their lives, and they're rank ordered according to how much
stress they typically induce.

BARLOW: Right. For example, the death of a spouse was
given one hundred points.

MISHLOVE: That would be about at the top of the scale.

BARLOW: That was the top of the scale, that's right. There's
been a lot of question about that scale. It does not show a strong correlation.
If you look at the research very carefully, it's very limited in its applicability.
But there have been some interesting things done with it. There's a woman
named Suzanne Kobasa who did her original research in the Midwest at the
University of Chicago, and what she did was she took people who had a lot
of points on this scale, which would indicate basically change.

MISHLOVE: A lot of points might be getting a divorce,
going bankrupt, getting fired from your job, all at the same time.

BARLOW: And other things too -- Christmas vacation, getting
a parking ticket. They were also given points, but a fewer number.

MISHLOVE: Don't positive experiences also cause stress?

BARLOW: That's right -- getting married.

MISHLOVE: Getting a promotion might cause as much stress
as a negative experience.

BARLOW: What the Holmes-Rahe Scale was trying to look
at was change. But when you look at the research pretty closely what you
see is that the correlations on that research are not so strong. You know,
that scale has been in every magazine article that anybody can read, and
the research is just not as strong around that as you might think. What
I was going to say was that Kobasa took this study and identified people
with high numbers of scores, and then she said, I'm going to look at the
ones who remain healthy. Who are the people who have a lot of change in
their life who remain healthy? Basically what she said is that they have
high self esteem. She said they were actors rather than vegetators; when
they had a problem they tended to move towards action rather than sitting
with it. And they had their life goals in order; they knew what their priorities
were, so when something happened they could measure it against that. They
also had what the psychologists call an internal locus of control; that
is, when something happened to them, they saw that they were responsible
for it, rather than they were a victim of their surroundings.

MISHLOVE: In other words, people who tend to blame would
be those who are holding more stress in their bodies?

BARLOW: That's right. Well, you don't have much control
if you're blaming.

MISHLOVE: Let me get back to that phrase I used -- holding
stress in the body. Some people, if they have a stress response, they get
upset, they can get angry, they get the various physiological concomitants
of that response. I suppose the shoulders move up like this, stomach tightens,
throat might get dry -- different things for different people. But they
discharge it right away; they get it out of their system.

BARLOW: Do they?

MISHLOVE: Well, some people do.

BARLOW: Some people do.

MISHLOVE: I know some people do. They may go out and have
a run.

BARLOW: Right.

MISHLOVE: Or they exercise, or they go out and hit a punching
bag.

BARLOW: Right.

MISHLOVE: They get rid of that, and then they're back
to normal.

BARLOW: Then they're back to normal, and then the body
can endure some more. I think it's very important for people to understand
that their bodies can endure enormous amounts of stress. What the body
can't endure is enormous amounts of stress for prolonged periods of time;
that is to say, no break from it.

MISHLOVE: So if you hold on to it, if you get stressed
and you don't know how to discharge the stress, that could be a problem.

BARLOW: That's the problem. Or you don't even know that
you've got it, and that's maybe one of the big problems.

MISHLOVE: I understand in your workshops typically people
are carrying a lot of stress that they're not aware of.

BARLOW: Totally. They have no idea that their shoulders
are up; they have no idea that their jaws are clenched. Frequently people
in my seminars will tell me that they didn't learn that they had a problem
with bruxism, which is the unconscious grinding of the teeth, or the holding
of the jaw tight, until they went to see a dentist, and their dentist told
them that they were grinding their molars flat; only then were they aware
that they were doing this. You know, it takes quite a bit to grind your
molars flat, and to be unaware of this is quite a state of denial.

MISHLOVE: So this is common.

BARLOW: Very common, extraordinarily common. In fact,
one of the jokes that I make in my seminars, after people list all the
things that they go through, all of the indicators that they have that
they're under stress, is to say to them, "You know, you may think that
you're the sickest group in the world, but you're not. If you went out
in the street and asked people randomly as they went by, you'd see that
they've got the same problems."

MISHLOVE: So many people must go through their lives thinking
that a state of living with a clenched jaw or a tight stomach or tight
shoulders is normal-natural.

BARLOW: Normal-natural.

MISHLOVE: "Everybody does this, don't they?" Sort of like
that.

BARLOW: Right. And that's how you get people dropping
dead of heart attacks, and their friends will say about them, "You know,
he was never sick a day in his life. How did that happen?" Well, it doesn't
happen like that. You really have to work hard to destroy your heart. You
have to work hard to destroy your body. It's built for the long haul.

MISHLOVE: You yourself were at one time a person who was
experiencing a high degree of stress.

BARLOW: That's for sure.

MISHLOVE: You became a stress management trainer by learning
how to manage and control your own stress first.

BARLOW: It came out of my own personal experience. I had
heart disease as a child, and I was hyperkinetic. What I did as a child
was I got out of things by getting sick and breaking bones, and it's unfortunately
something I have to watch even to this day. If I'm doing something that
I don't want to do, I'm very likely to fall down, and I really have to
be careful about this, because my natural tendency to withdraw, my flight
mechanism, is to hurt myself, and I don't like that in myself, but I have
to admit that it's a part of my personality.

MISHLOVE: At one time you also had a big coffee habit,
I understand.

BARLOW: Oh, I grew up with the notion that people who
couldn't do whatever they wanted to do were weak, and that if you needed
to sleep more than two hours a night, that there was something wrong with
you. Of course people need to sleep more than two hours a night, or at
least most people do. And so I just drank enormous amounts of coffee, and
I ate No-Doz pills straight. I was so hyper that there were times that
I literally couldn't feed myself. The food would fall off the fork because
I was keeping myself in such a state of heightened awareness. I say today
that I'm extremely lucky that I was in college at a time when amphetamines
weren't readily available as they are today on the campuses. I have enormous
sympathy for these youngsters going through the enormous stress of getting
their education, and having all of these drugs available to them to take
them up, to take them down, to play with their moods. It's very hard to
avoid that.

MISHLOVE: So one of the ways that we stress ourselves,
sometimes deliberately, is through using coffee, sugar, tobacco, alcohol,
things of this sort?

BARLOW: Oh yes, the coffee especially. You sit down and
the waitress or waiter comes up to you, and it's assumed that you're going
to have a cup of coffee. Most people have a hard time getting started in
the day without that cup of coffee.

MISHLOVE: How does that cause stress?

BARLOW: Well, what it does inside the body is it's a central
nervous system stimulator, so it affects the adrenal glands, and the adrenalin
makes the heart beat faster, makes the muscles get tighter, makes you think
clearer, at least initially. It's if you use too much of it that is the
problem.

MISHLOVE: By stimulating the adrenal glands.

BARLOW: Yes. It's a total body system response. You don't
just stimulate one part of it. Everything gets stimulated. And it can happen
as a result of the pressures that people put on themselves towards achievement,
and that's I think where a big part of the stress comes from. In my own
case, it was probably an overachiever's attitude when I was eighteen, nineteen,
twenty. I graduated from high school when I was eighteen. I had my first
Master's degree before I was twenty-one, and I also had my first set of
ulcers. I was in pretty bad shape. It was in 1972 that I finally made some
decisions to change my life, and it was done because doctors told me that
I wouldn't live to forty if I didn't do that, so I got motivated to change
my life. And what I found, which has been the most interesting thing in
the whole field of stress for me, is that you can learn how to manage your
stress without having to reduce the amount of activity that you have in
the world. You don't have to become a low achiever to manage your stress
well.

MISHLOVE: Well, you're certainly an example of a high-achieving
person who does, I presume, manage their stress.

BARLOW: I think I'm managing my stress well. I'm forty-four
now, and I think that I'm in better shape than I've ever been before; at
least it feels that way. But I can also feel, because I do a lot of traveling
in my work, I can feel when it gets out of control for me, and if there's
one advantage I have that maybe other people don't have, it's that, because
I teach this subject, I'm constantly monitoring, constantly aware as to
what my body's doing, so I don't let it get to a point where I'm out of
control.

MISHLOVE: So your first rule, if you were to tell people
how to handle their stress, would be just to be aware of it.

BARLOW: Exactly. There was a study done at Stanford Medical
Center a number of years ago now. It was quite a telling one, in which
they were interested in why so many people had lower back pains. It's the
number-one cause of disability in the United States, lower back pains --
lower back injuries or pain to such a point that the person has to quit
their job. So they were interested in this, and how they conducted the
study was to put a belt around the participant's hips, and on one side
of the belt was a sensitive biofeedback device which would measure muscular
contractions. It had electrodes which came around and attached to the lower
back. When the lower back got tight to a certain degree, the machine registered
this, and then it emitted a high-pitched sound, something like this: "Eeeeeeee."
At this point the participants were instructed: "Go to this side of your
belt, take off the pad of paper and pencil and write down what you were
doing." It was very clever. Then they could say if somebody walked by somebody's
office, that person was the stressor; if it was the telephone -- it was
a very good attempt. But the problem that the researchers ran into was
that after three weeks they had to discontinue the study. Now, it's interesting
to get people to guess why the study had to be discontinued.

MISHLOVE: I suppose it was because it was going off all
the time.

BARLOW: That's what most people will say, or they ran
out of paper and pencils because there were so many stressors. But the
answer is that the beeper stopped going off; in other words, the participants
stopped tightening their lower back.

MISHLOVE: In other words, because they were becoming aware,
through this process of biofeedback, which is what you've set up here.
Through awareness we can learn to relax.

BARLOW: That's right.

MISHLOVE: And I guess relaxation itself is the antidote
to the stress response.

BARLOW: Letting go of it, yes. Relaxation doesn't have
to mean sitting down with your eyes closed for twenty minutes, or taking
a nap. It doesn't have to mean that. Once people learn how to do simple
relaxation techniques, and if they are aware, so they don't let it get
too bad -- because if it gets really bad, you need to take a vacation;
sometimes people need to do this -- but if you have it just a little bit
and then notice it and let go of it, and have a little bit more, notice
it and let go of it, that's what the body's really built for.

MISHLOVE: Just as we can consciously tighten up, we can
also consciously let go.

BARLOW: Right, but you need to know that you're tight.
That's what people have a hard time with.

MISHLOVE: There's a lot of research lately, isn't there,
that suggests that the immune response is related to the stress response.

BARLOW: But that's not just lately; that's been known
for some time. Hans Selye, the father of the concept of stress, the Canadian
who died a few years ago -- that was part of his original research. Definitely
the immune system gets involved with it. I think maybe what you're referring
to in terms of recent research is there's a lot of connection with this
-- identifying, for example, somebody's in a bad marriage, and seeing if
their immune system is affected by this, and yes, it is. One of the glands
in the body, the thymus gland, which is partly responsible for the production
of white blood cells, actually atrophies when a person is in a highly stressed
state for a long period of time.

MISHLOVE: I suppose if a person, even if they're not in
touch with what their body's doing, if they're chronically feeling depressed
--

BARLOW: Tired.

MISHLOVE: -- or tired, that would be indicative of a stress
response.

BARLOW: Or their emotions are out of control; that would
be another indicator. You know, it's probably safe to say, when people
look at the question of does stress cause illness, because that's still
a controversial question, it's probably safe to say -- well, let me put
it this way: You can't say that stress causes illness; that would be an
overstatement of what stress does. But in every case where you have illness,
what you'll probably see is something, some piece of stress is involved
with it.

MISHLOVE: Stress could certainly exacerbate that sort
of thing.

BARLOW: That's right.

MISHLOVE: A concept that you use frequently is the notion
of self talk, monitoring your self talk. How does this relate?

BARLOW: Well, our self talk affects what we think about
a situation. A way to look at it is that when you're dealing with a social
stressor you're not really looking at reality; what you're looking at is
your interpretation of that reality, and your self talk is that interpretation
of that reality. So you could have -- well, here's an example. There's
a woman that I read about in the newspaper that caught my eye -- fifty-six,
widowed for the first time, which is when the average woman in this country
is widowed for the first time, incidentally. Her children were grown, and
she decided she wanted to fulfill a long-term fantasy, which was to become
a Roman Catholic nun. She agreed to do this on one condition, which was
that the convent that she joined would allow her to work in a Mexican jail.
Now, most people would say, "Do everything you can to avoid being in a
Mexican jail." Well, this woman's self talk about being in that Mexican
jail is obviously different from somebody's self talk who's trying to avoid
being in that Mexican jail.

MISHLOVE: In other words, if you're constantly involved
in situations, and your mind is always saying, "This is horrible. This
is terrible. This is bad."

BARLOW: "This is a problem." A piece of research done
on that, that was very simple -- they looked at people who used the word
problem; they looked at people who used -- it could be any number of phrases,
but something along the line of, "This is an opportunity." For example,
people who said, "We've got a problem down in Marketing," or, "We've got
a problem with that person over in the typing pool," versus the people
who said, "You know, there's a situation down in Marketing that deserves
our attention," or, "There's somebody over in the typing pool who needs
a little more careful supervision now." Those people who used the latter
phrases had a reduced stress response compared to the people who identified
their situations as problems. A simple shifting of a word seemed to make
a difference in a person's reaction to the same situations, and that's
why self talk is important.

MISHLOVE: You know, one of the intriguing things I find
in the field of stress management in general is that there are people like
yourself who are now going into corporations and teaching corporate executives
to do things that would have once been considered unthinkable, like meditation.

BARLOW: Right, yes.

MISHLOVE: Let's talk about the role of these kinds of
practices. What do you recommend, beyond what we've discussed already?

BARLOW: Well, let me just talk about how unusual it is,
for just a second. Ten years ago, or eleven years ago, when I first went
into businesses, I think I may have been one of the first people to go
in and do practical workshops. There may have been somebody else, but I'm
not aware of them. Now everybody is getting on the bandwagon and offering
stress management courses. It's not considered a weakness to go to a stress
management course today.

MISHLOVE: No, it's standard management training.

BARLOW: That's right, and everybody wants to hear about
it. Even if they've heard about it before, they want to hear about it,
because they need to be reminded. And people are very receptive to a wide
variety of strategies. What I do in my programs is I try to hit as many
different people's needs as possible. Some people want to hear about exercise;
we talk about that. Some people want to do relaxation exercises, and we
do relaxation/meditation kinds of exercises. I put a heavy emphasis on
what I call quick-and-dirty techniques, things that people can do without
taking time -- things that you can do in a meeting, for example; teaching
people how to breathe with their eyes open, to relax their diaphragm, to
relax their muscles, simple kinds of things. Because people aren't going
to do difficult things.

MISHLOVE: One of your techniques, which I think is quite
remarkable, is just to put little reminders up in certain locations, near
the telephone or the refrigerator, reminding people just to watch their
level of stress, watch their breathing.

BARLOW: Right, because it's so easy to make yourself relaxed.

MISHLOVE: I suppose one or two deep breaths can really
make a big difference.

BARLOW: Absolutely. It starts the cycle of moving towards
the parasympathetic nervous system response, the relaxation response. Just
as something can move you into the stress response, something can start
to move you out of it.

MISHLOVE: What about people who come and tell you that
they find that their religion or their spiritual approach is the way that
they manage stress?

BARLOW: I have no problem with that. I think that's totally
appropriate. If you look at certain countries -- Haiti, Dominican Republic,
where there's tremendous poverty, a tremendous amount of environmental
stressors that these people are facing -- they have very, very low cardiovascular
problems, and it seems to be their religious attitude. That's self talk.

MISHLOVE: That's interesting.

BARLOW: It's their religious attitudes that seem to be
keeping them from some of the degenerative diseases that we face in the
United States, for example.

MISHLOVE: In other words, if they have an attitude of
pride in what they do, and a feeling of connection, of harmony somehow
with the universe, through their religion, that's a stress management tool.

BARLOW: That's right, because then they can endure. If
you perceive your burdens, as some religious people do, as opportunities
to bear a cross, well, then that problem is not a problem. Some people
have handicapped children; they look upon the child as providing an opportunity
for them to learn how to love. It's just different self talk about a situation
that could destroy a family.

MISHLOVE: Well, stress seems to be something that's increasing
in the environment. We hear more and more about toxic chemicals in the
environment, about air pollution, about water pollution, in spite of twenty
years of environmental efforts. It seems as if these kinds of skills, which
have in the last ten years just been moving into the business community,
are going to have to become more widespread in our culture, because the
amounts of our stressors are not decreasing.

BARLOW: Right, but what you were just listing were a bunch
of physical stressors, and ultimately I'm not so sure that these strategies
will work against a preponderance of physical stressors. That in my mind
is a totally different subject.

MISHLOVE: You can't breathe away toxins in the environment.

BARLOW: Maybe you can, but you'd have to do a lot of breathing.

MISHLOVE: At some point you have to try and attack the
stressor directly.

BARLOW: That's right.

MISHLOVE: You have to make a decision as to what you can
deal with internally, and what you want to deal with through political
and social action.

BARLOW: Right. But for example, most of the social stressors
are here to stay -- for example, economic instability, differences between
races, differences between us socially, religion. Those things aren't going
to go away. The crowdedness, that isn't going to go away. So we have to
learn how to adjust to some of these things -- deadlines that people face
in their businesses; the fact that American business today is getting leaner
and leaner staffed; people's jobs are getting larger and larger, with fewer
and fewer resources to do them.

MISHLOVE: Merger mania.

BARLOW: And we have to do it to stay competitive.

MISHLOVE: The pressure to be more efficient is a source
of stress.

BARLOW: That sort of thing you really can't do anything
about, so what you have to do then is to learn to accept it, and learn
how to gauge your own response in relationship to it.

MISHLOVE: Dr. Janelle Barlow, it's been a pleasure having
you with me. You've really exemplified, not only through your discussion,
but in your life itself, what it means to manage stress.